title: Prognostic value of peritumoral edema and angiogenesis in intracranial meningioma surgery.
abstract: OBJECTIVE
  In a series of 78 consecutive patients we analyzed the influence of peritumoral edema (PTE) and angiogenesis (vascular endothelial growth factor/ VEGF expression) on the prognosis of morbidity and postoperative complications after intracranial meningioma surgery.
  
  
  METHODS
  A retrospective analysis was performed of clinical, neuroradiological and histological data of 78 microsurgically treated patients with intracranial supratentorial meningioma, with follow-up period of at least one year.
  
  
  RESULTS
  The severity of PTE showed significant correlation with VEGF expression, and all patients with large PTE (>40 mm) had strong VEGF expression (>50%). Treatment outcome was significantly better in patients with low VEGF expression (p<0.05). All of the monitored postoperative complications were more frequent in the group with PTE.The duration of intensive care treatment in the group with PTE (mean 6.85 days) was significantly longer than in the group without PTE (mean 3.68 days) (p=0.003). In the group without PTE, the outcome was significantly better than in patients with PTE (p<0.01).
  
  
  CONCLUSIONS
  PTE in intracranial meningiomas has significant influence on the prognosis in surgically treated patients in terms of increased risk of morbidity and postoperative complications. VEGF expression is strongly correlated with PTE formation, which also affects the outcome in the management of patients with intracranial meningioma.
authors.affiliation: Department of Neurosurgery, Clinical Hospital Center Zemun, Belgrade, Serbia.
authors.forename: M
authors.initials: M
authors.lastname: Markovic
authors.forename: V
authors.initials: V
authors.lastname: Antunovic
authors.forename: S
authors.initials: S
authors.lastname: Milenkovic
authors.forename: N
authors.initials: N
authors.lastname: Zivkovic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D001929:Brain Edema / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000098:blood supply* / Q000737:chemistry / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000098:blood supply* / Q000737:chemistry / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008866:Microsurgery / Q000009:adverse effects / Q000401:mortality; D008875:Middle Aged; D009389:Neovascularization, Pathologic; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D015173:Supratentorial Neoplasms / Q000098:blood supply* / Q000737:chemistry / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A